Business Travel Health

Revisiting Jet Lag -- Your Comments and Opinions.
-- By Frank Gillingham, MD

My column concerning jet lag seemed to be of great interest to a number of readers and I received many wonderful emails in response--thanks again to all who took the time to share their experiences.

One general conclusion that your feedback suggests is that managing jet lag is extremely personal. Just as you need to pick your own mattress (soft or firm?), pillow (thin or thick?), and lighting arrangements (shades up or down?) to sleep well at home, you will need to experiment to find the right environment that will allow you to sleep well on a plane or in your new time zone. Many readers reported that they have licked jet lag through habits developed over time, without the use of expensive devices or medications.

While it would be difficult to summarize all of the comments received, I have noted below the most common suggestions and have included some of my opinions as well.

• Hydration. Several readers pointed out correctly that staying well hydrated is a key part of jet lag management--and general travel health. Great point. Drink lots of water or fruit juice; avoid alcohol and caffeine-containing beverages.
  
  
• Traditional Medications. Readers reported good experiences with the medications such as Ambien--some actually reported preferring the more traditional treatment, Halcion. While many physicians have stopped prescribing Halcion for jet lag because of reports of long lasting amnesia, these two travelers hadn't had problems with this effect--in fact, one of them was glad not to be able to recall the plane ride.
  
  
• Non-Traditional Medications. Several readers reported good success with non-traditional medications and agents. Popular remedies mentioned include "No Jet Lag " (a homeopathic remedy that requires you to chew tablets every couple of hours during a flight), and an herbal supplement called Valerian. Some of you (but not all) had good luck with Melatonin. One reader, who identified himself as a medical doctor (M.D.) and doctor of philosophy (Ph.D.), reported good success with two proprietary preparations called Prime 1 and Brekhman's Gold.

  My general feeling on the use of these agents for the treatment of jet lag is to use caution. As I noted in the original article, I'm hesitant to ingest or recommend unknown compounds to treat jet lag, a condition which will eventually go away anyway.

  A digression on the use of medications for any condition. I subscribe to the general rule that you should only use a medication to treat a problem if no less-invasive alternative exists. If you choose to use a medication, you and your physician should try to follow the following rules: (1) use the oldest medication available that has a track record of success and safety for the condition in question--the older the medication, the longer the history of safety; (2) use a medication that is approved for use by the FDA or, potentially, a similarly thorough drug regulatory agency in another country (this is important not only because of the initial approval process but because of the ongoing safety monitoring that the FDA performs); (3) use a medication that is manufactured by a reliable pharmaceutical company, to maximize the chance that you're actually getting what you think you're getting. Unfortunately, many of the non-traditional jet lag remedies don't meet one or more of these criteria. These are general rules and many of you will be able to cite perfectly valid situations in which one or more of them should be ignored. But I find them a helpful guide.

• Spas. A couple of readers had very good experiences with spas or saunas/hot tubs as a way to induce sleep and relax in their destination. One reader correctly pointed out that as your body temperature falls you become sleepy--which might explain why a hot bath works so well for some people.
  
  
• Environmental Adaptation. Many readers made suggestions that fall into the realm of common sense but are easy, cheap and safe. For example, you might try a window seat to avoid having to get up when your row-mates get up; try eye shades and/or ear phones for quiet on the plane; once in your destination don't overstimulate yourself with computer games and telephone calls home around bed time. Many readers felt strongly that avoiding napping on West to East flights was absolutely essential. Many readers found exposure to natural light critical to their adaptation.
  
  

  I am in favor of experimenting with these simple but safe strategies. Unless you travel long distances very frequently you may need to keep a journal to remind yourself from trip to trip what methods you tried before and how you felt.

• Other Clever Suggestions. One reader who travels frequently to Europe suggested Roller Blades as a solution on West to East flights. "On the first day, towards late afternoon when I can't stay awake," she wrote, "I put them on and cruise around (slowly) by the shore of the lake. There is no possible way to fall asleep while standing on skates, and if you go slowly, then it is possible to go for a long time (until dinner) without being tired. This also helps with the sunlight effect." [Cautious doctor note: Don't try this unless you know how to roller blade! And wear a helmet!]

  Finally, my favorite suggestion: boring airplane movies! One reader made this suggestion after "Liar, Liar", a Jim Carrey movie, woke her up and kept her alert during an entire transatlantic flight to Paris. There are probably certain movies that are just too funny for overnight flights--and there's no shortage of dull movies that might help combat jet lag. If you'd like, send me your film suggestions: Best (and Worst) Movie(s) for Inducing Sleep on an Overnight Flight!